刍议腹腔镜无张力疝修补术

Discussion on Laparoscopic Hernia Repair

目的评价腹腔镜无张力疝修补术治疗成人腹股沟疝的临床疗效、安全性。方法方便选取该院2016年6月—2017年5月收治的98例成人腹股沟疝患者根据先后入院顺序分为对照组、研究组,对照组患者的术式为开放性无张力疝修补术,研究组患者的术式为腹腔镜无张力疝修补术,比较两组患者手术用时、术中出血量、术后下床活动时间、手术并发症发生情况及术后随访6个月的疾病复发情况。结果研究组手术用时为(60.02±6.96)min,较对照组的(49.15±5.88)min长(t=5.335;P<0.05),术中出血量为(10.31±2.15)mL,较对照组的(29.47±7.01)mL少(t=11.686;P<0.05),术后下床活动时间为(13.09±3.52)h,较对照组的(19.24±3.81)h早(t=5.302;P<0.05),手术并发症发生率为2.04%,较对照组的12.24%低(χ~2=3.846;P<0.05)。术后随访6个月,两组中均无疾病复发病例。结论应用腹腔镜无张力疝修补术治疗成人腹股沟疝,能够获得确切的近远期疗效,且与开放性无张力疝修补术比较,创伤性更小,安全性更高,患者术后恢复更快。

Objective This paper tries to evaluate the clinical efficacy and safety of laparoscopic tension-free hernia repair in adult inguinal hernia. Methods 98 adult patients with inguinal hernia admitted from June 2016 to May 2017 in the hospital were convenient selected and divided into a control group and a study group according to the order of admission. The open-type tension-free hernia repair was performed on the patients of the control group. The surgical procedure was laparoscopic tension-free hernia repair of the study group. The time of surgery, intraoperative blood loss, postoperative ambulation, postoperative complications, and disease recurrence after 6 months of follow-up were compared between the two groups. Results The duration of surgery in the study group was（60.02 ±6.96） minutes, which was longer than that of the control group（49.15±5.88）minutes（ t = 5. 335; P 0. 05）. The intraoperative blood loss was（ 10. 31 ± 2. 15） mL, which was higher than that of the control group（29.47±7.01）mL（t=11.686; P〈0.05）, and the time of getting out of bed was（13.09±3.52）h, which was earlier than that of the control group（19.24±3.81）h（t=5.302; P〈0.05）. The incidence of surgical complications was 2.04%, which was lower than 12.24% in the control group（χ^2=3.846; P〈0.05）. After 6 months of follow-up, there were no recurrences of the disease in both groups. Conclusion The application of laparoscopic tension-free hernia repair in adult inguinal hernia repair can achieve exact near-and-long-term efficacy, and is less traumatic, safer, and faster postoperative recovery than open tension-free hernia repair.